How to Pay for In-Home Care
How to Pay for Home Care in Missouri
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists Missouri-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. Missouri's strongest state-specific pathways include Consumer Directed Services, the Structured Family Caregiving Waiver, the Aged and Disabled Waiver, the Independent Living Waiver, and PACE, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible Missouri veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Missouri Medicaid / State Plan
Agency Model Personal Care (Basic & Advanced)
Direct home-care payerHelps pay for: MO HealthNet can authorize agency-delivered personal care for help with ADLs/IADLs, including more intensive advanced personal care when assessed and authorized.
Who qualifies: MO HealthNet/HCBS eligibility; assessed need and person-centered care plan; service limits and provider rules apply.
How to start: Request an HCBS assessment through DSDS HCBS Intake/PCCP.
Good to know: Family caregiver payment: No - immediate family cannot be the Agency Model caregiver.
Authorized Nurse Visits
Yes - skilled careHelps pay for: Can authorize nurse visits for medically necessary assessment, monitoring, teaching and other covered nursing functions under the state-plan HCBS benefit.
Who qualifies: MO HealthNet eligibility; medical need; authorization and provider rules apply.
How to start: Ask DSDS or the treating clinician whether Authorized Nurse Visits belong in the care plan.
Good to know: Family caregiver payment: No.
Missouri Medicaid / Self-Direction
Consumer Directed Services (CDS) Personal Care Assistance
Direct home-care payerHelps pay for: Lets an eligible participant recruit, hire, train, schedule and supervise a personal care attendant; the participant is employer-of-record and the enrolled CDS provider processes payroll.
Who qualifies: Age 18+; physical disability; active MO HealthNet; nursing-facility level of care; able to self-direct; other program rules apply.
How to start: Tell HCBS Intake/PCCP you want Consumer Directed Services and complete the assessment/provider-selection process.
Good to know: Family caregiver payment: Yes - family allowed except spouse or legal guardian.
CDS Essential Transportation & IADL Support
PartialHelps pay for: Authorized CDS personal care may include essential transportation and assistance with qualifying instrumental activities tied to the participant’s disability and care plan.
Who qualifies: Must be part of an authorized CDS care plan; ordinary shared household tasks are not automatically covered.
How to start: Ask the assessor which transportation/IADL tasks can be included in the PCCP.
Good to know: Family caregiver payment: Yes - through an eligible CDS attendant.
Missouri Medicaid / Waiver
Adult Day Care Waiver
Offsets care costHelps pay for: Provides Medicaid adult day care for qualifying participants, offering daytime supervision, personal assistance and structured supports that may reduce in-home care hours.
Who qualifies: MO HealthNet/HCBS eligibility, assessed need, waiver criteria and available program capacity apply.
How to start: Request screening through DSDS HCBS Intake/PCCP.
Good to know: Family caregiver payment: No.
Aged and Disabled Waiver (ADW)
Yes / supports community livingHelps pay for: HCBS waiver for qualifying older adults who would otherwise require nursing-facility care; can authorize homemaker, chore, home-delivered meals, respite and adult day care.
Who qualifies: Generally age 63+; MO HealthNet; assessed impairments/unmet needs and nursing-facility level-of-care criteria.
How to start: Request an HCBS assessment through DSDS.
Good to know: Family caregiver payment: No direct caregiver cash.
Independent Living Waiver (ILW)
Direct home-care payerHelps pay for: Adds waiver supports for eligible CDS participants with greater needs, including additional personal care plus case management, financial management and specialized supports.
Who qualifies: Initial entry generally age 18-64; physical disability; self-direction; active MO HealthNet; nursing-facility level of care; must meet ILW criteria.
How to start: Start through DSDS HCBS Intake/PCCP and ask whether ILW is appropriate.
Good to know: Family caregiver payment: Yes for consumer-directed personal care, subject to CDS worker rules.
Missouri Medicaid / ADW
ADW Homemaker
Direct home-care payerHelps pay for: Can provide authorized household and supportive tasks needed to help an eligible participant remain safely at home.
Who qualifies: ADW eligibility; assessed need and authorization in the person-centered care plan.
How to start: Ask the DSDS assessor about homemaker hours.
Good to know: Family caregiver payment: No - provider-based.
ADW Chore Services
PartialHelps pay for: Can cover authorized heavier household tasks necessary for health and safety that are beyond routine homemaker services.
Who qualifies: ADW eligibility; task must be assessed, allowable and authorized.
How to start: Ask the DSDS assessor whether chore services fit the identified need.
Good to know: Family caregiver payment: No - provider-based.
ADW Home-Delivered Meals
Offsets care costHelps pay for: Can cover authorized home-delivered meals for eligible ADW participants, reducing food and meal-preparation burden.
Who qualifies: ADW eligibility and care-plan authorization; current reimbursement rules and meal limits apply.
How to start: Ask the DSDS assessor to screen for home-delivered meals.
Good to know: Family caregiver payment: No.
ADW In-Home Respite (Basic & Advanced)
Yes - respiteHelps pay for: Can provide authorized in-home respite so an unpaid caregiver can take a break while the participant remains safely supported.
Who qualifies: ADW eligibility and assessed respite need; effective July 1, 2026, ADW respite is subject to a 49-hour-per-week service limit.
How to start: Request respite through DSDS and the person-centered care plan.
Good to know: Family caregiver payment: No direct wage to the primary caregiver.
ADW Adult Day Care
Offsets care costHelps pay for: Adult day care can provide daytime supervision, personal assistance, meals/activities and health-related support, reducing the need for some paid in-home hours.
Who qualifies: ADW eligibility, assessed need, provider availability and authorization.
How to start: Ask DSDS about adult day care under the ADW.
Good to know: Family caregiver payment: No.
Missouri Medicaid / ILW
ILW Additional Personal Care + Case/Financial Management
Direct home-care payerHelps pay for: Can add consumer-directed personal care beyond state-plan CDS limits and provide case-management/financial-management supports.
Who qualifies: ILW eligibility and central approval; effective July 1, 2026, ILW services are subject to a 49-hour-per-week service limit.
How to start: Ask the CDS/DSDS team to evaluate ILW need and authorization.
Good to know: Family caregiver payment: Yes - eligible family except spouse/legal guardian for personal care.
ILW Accessibility, Equipment & Medical Supplies
Offsets care costHelps pay for: Can fund approved environmental accessibility adaptations, specialized medical equipment and specialized medical supplies that support community living.
Who qualifies: ILW eligibility; item/service must be authorized and meet waiver requirements.
How to start: Discuss accessibility/equipment needs with the ILW case manager.
Good to know: Family caregiver payment: No.
Missouri Medicaid / Dementia Waiver
Structured Family Caregiving Waiver (SFCW)
Direct home-care payerHelps pay for: Dementia-focused waiver that supports care in the participant’s home and includes a provider-administered daily structured-family-caregiving service/stipend.
Who qualifies: Participant has Alzheimer’s disease or related dementia, lives with the primary caregiver, cannot receive another HCBS/waiver service; primary caregiver may not maintain outside employment; other eligibility/authorization rules apply.
How to start: Request SFCW screening through DSDS HCBS Intake/PCCP.
Good to know: Family caregiver payment: Yes - structured primary caregiver arrangement.
Missouri Medicaid / Complex Medical
Medically Complex Adult Waiver (MCAW)
Yes - medical/personal careHelps pay for: For qualifying adults with serious and complex medical needs; may authorize private-duty nursing, in-home personal care, nurse visits, specialized supplies/equipment and service coordination.
Who qualifies: Missouri resident age 21+; MO HealthNet fee-for-service; qualifying institutional level of care; not in another waiver; prior qualifying medically complex youth/private-duty-nursing history.
How to start: Contact Special Health Care Needs or a regional office for referral.
Good to know: Family caregiver payment: Generally provider-based.
Missouri Medicaid / Medical
MO HealthNet Home Health / Skilled Care
Yes - skilled careHelps pay for: MO HealthNet may cover medically necessary skilled home health, nursing, therapy and related services under applicable Medicaid benefit and authorization rules.
Who qualifies: MO HealthNet eligibility, medical necessity, provider enrollment and authorization requirements apply.
How to start: Ask the treating clinician and MO HealthNet about home-health coverage.
Good to know: Family caregiver payment: No.
Missouri Medicaid / Integrated Care
PACE
Direct home-care payerHelps pay for: Program of All-Inclusive Care for the Elderly integrates Medicare/Medicaid medical care and LTSS and may arrange home care, personal care, meals, transportation, therapy, equipment and respite.
Who qualifies: Age 55+; nursing-home level of care; live in a Missouri PACE service area; able to live safely in the community; payer rules apply.
How to start: Contact a PACE organization serving the ZIP code or MO HealthNet.
Good to know: Family caregiver payment: No direct cash.
Missouri Medicaid / Transition
Show-Me Home / Money Follows the Person
Offsets care cost / enables home careHelps pay for: Helps eligible people transition from a nursing facility to a home/community setting and can coordinate services and eligible transition supports.
Who qualifies: Generally requires MO HealthNet eligibility and qualifying institutional stay/transition criteria; individual screening applies.
How to start: Ask the facility social worker or Show-Me Home transition team.
Good to know: Family caregiver payment: No.
Missouri LTSS Navigation
Missouri Care Options
Navigation to funded careHelps pay for: State long-term-care counseling/screening program that helps Medicaid-eligible or potentially eligible adults consider home- and community-based alternatives to nursing-facility placement.
Who qualifies: Adults 18+ who need long-term care and are Medicaid eligible or potentially eligible; individual screening applies.
How to start: Request a Missouri Care Options consultation.
Good to know: Family caregiver payment: No.
Missouri Aging / In-Home Services
AAA In-Home Services - Personal Care & Homemaker
Yes / subsidizedHelps pay for: Local Area Agencies on Aging may fund or arrange personal care, homemaker, homebound shopping, medication setup and other supports for older adults.
Who qualifies: Generally age 60+; need, priority and local funding/provider availability vary by AAA.
How to start: Call the Senior Resource Line for the local AAA and ask for an in-home-services assessment.
Good to know: Family caregiver payment: Usually no ongoing family wage.
Missouri Aging / Respite
AAA Respite Services
Yes - respiteHelps pay for: Area Agencies on Aging may provide or subsidize short-term respite for family/informal caregivers.
Who qualifies: Caregiver/care-recipient eligibility and local funding vary; Older Americans Act priorities apply.
How to start: Contact the local AAA/caregiver program.
Good to know: Family caregiver payment: Usually no ongoing caregiver wage.
Missouri Aging / Home Safety
AAA Home Modifications, Assistive Technology & PERS
Offsets care costHelps pay for: Local aging programs may provide limited home modifications/repairs, assistive technology, durable equipment or emergency-response supports that make remaining at home safer.
Who qualifies: Age/need, local program rules and available funds vary.
How to start: Ask the local AAA about home modifications, assistive technology and emergency-response options.
Good to know: Family caregiver payment: No.
Missouri Aging / Dementia Caregiver
Missouri Caregiver Program
Partial / respite / reimbursementHelps pay for: Dementia caregiver program offering education/training, respite, assistive technology and partial reimbursement for qualifying care-related expenses when funding is available.
Who qualifies: Caregiver lives with a Missouri care recipient who has probable Alzheimer’s disease or related dementia; funding is limited and first-come/available.
How to start: Contact the current program contractor or DHSS for screening.
Good to know: Family caregiver payment: Not an ongoing caregiver wage.
Missouri Aging / Caregiver Support
National Family Caregiver Support Program
Partial / respiteHelps pay for: Through AAAs, can provide information, counseling/support, caregiver training, respite and limited supplemental services such as minor home modifications or supplies.
Who qualifies: Caregiver eligibility depends on age/relationship/care-recipient rules under the Older Americans Act; local availability varies.
How to start: Contact the local AAA caregiver-support program.
Good to know: Family caregiver payment: No ongoing caregiver wage.
Missouri Aging / Nutrition
Home-Delivered Meals
Offsets care costHelps pay for: Local aging nutrition programs can provide meals and wellness contact for eligible homebound older adults, reducing meal-preparation costs and caregiver time.
Who qualifies: Generally age 60+ with local eligibility/priority criteria; donations/cost-share policies and availability vary.
How to start: Call the Senior Resource Line for the local nutrition provider.
Good to know: Family caregiver payment: No.
Congregate Meals
Offsets care costHelps pay for: Senior nutrition sites can provide meals and social connection, reducing food expense and some daytime caregiver burden.
Who qualifies: Generally age 60+; spouse/other eligibility rules and local availability apply.
How to start: Contact the local AAA or senior center.
Good to know: Family caregiver payment: No.
Missouri Aging / Transportation
Transportation Services for Older Adults
Offsets care costHelps pay for: AAA transportation can include medical/general rides, paratransit, bus passes, volunteer drivers, ride-hailing and in some areas consumer-directed reimbursement to a family/friend driver.
Who qualifies: Generally age 60+ and, in some programs, adults 18-59 with disabilities; services vary by region.
How to start: Ask the local AAA which transportation models are available.
Good to know: Family caregiver payment: Driver reimbursement may be possible; not a caregiver wage.
Missouri Aging / Navigation
Area Agencies on Aging / Senior Resource Line
Navigation / may lead to funded careHelps pay for: Missouri’s 10 AAAs connect older adults and caregivers with in-home services, respite, meals, transportation, benefits counseling, legal help and other local supports.
Who qualifies: Service eligibility and funding vary; the Senior Resource Line routes callers by ZIP code.
How to start: Call the Senior Resource Line and request the local AAA.
Good to know: Family caregiver payment: Program-specific.
Missouri Aging / Community Support
Senior Centers
Offsets care costHelps pay for: Local senior centers provide meals, social programs, wellness activities, benefits connections and other services that can reduce isolation and household support needs.
Who qualifies: Local eligibility and program availability vary, generally serving adults age 60+ through the aging network.
How to start: Ask the local AAA for nearby senior centers and services.
Good to know: Family caregiver payment: No.
Missouri Food Assistance
SNAP
Offsets household costHelps pay for: Monthly food assistance loaded to an EBT card can reduce grocery spending and preserve household income for care.
Who qualifies: Household income and other SNAP rules apply.
How to start: Apply through myDSS or Family Support Division.
Good to know: Family caregiver payment: No.
Missouri Nutrition
Commodity Supplemental Food Program (CSFP)
Offsets household costHelps pay for: Monthly nutritious food package for qualifying low-income older adults can reduce grocery expense.
Who qualifies: Generally age 60+ and income at or below the program threshold; distribution-site availability applies.
How to start: Use the Missouri CSFP page to locate a local agency.
Good to know: Family caregiver payment: No.
Missouri Energy Assistance
Low Income Home Energy Assistance Program (LIHEAP)
Offsets household costHelps pay for: Energy Assistance and crisis intervention can reduce utility costs, preserving household income for home care and medications.
Who qualifies: Income, household and program-season requirements apply.
How to start: Apply through myDSS/local LIHEAP agency.
Good to know: Family caregiver payment: No.
Medicare
Medicare Home Health
Yes - skilled/limited aideHelps pay for: Original Medicare can cover qualifying intermittent skilled nursing, therapy and limited home health aide services when Medicare conditions are met.
Who qualifies: Homebound; skilled need; clinician order/plan of care; Medicare-certified home health agency.
How to start: Ask the clinician for a Medicare home-health evaluation.
Good to know: Family caregiver payment: No.
Caregiver Training Services
Offsets training costHelps pay for: Medicare Part B may cover training for a caregiver when a practitioner determines it is needed for the patient’s treatment plan.
Who qualifies: Must meet Medicare medical-necessity and coverage requirements.
How to start: Ask the treating practitioner whether caregiver training can be ordered.
Good to know: Family caregiver payment: No.
Medicare / Dementia
Medicare GUIDE Model
Partial / respiteHelps pay for: Participating dementia-care organizations provide navigation, caregiver support and qualifying respite for eligible Original Medicare beneficiaries with dementia.
Who qualifies: Original Medicare Parts A/B; dementia; other CMS eligibility rules; must be served by a participating GUIDE organization.
How to start: Find a GUIDE participant serving the ZIP code or call Medicare.
Good to know: Family caregiver payment: No direct stipend.
Medicare Advantage
Supplemental In-Home Benefits
Sometimes / limitedHelps pay for: Some Medicare Advantage plans offer limited in-home supports, meals, transportation or caregiver-related benefits beyond Original Medicare.
Who qualifies: Plan-specific and year-specific; authorization/network rules apply.
How to start: Review the current Evidence of Coverage and call the plan.
Good to know: Family caregiver payment: Usually no.
Missouri Medicare Counseling
Missouri SHIP
Offsets health costsHelps pay for: Free, unbiased counseling can help identify Medicare, Medicare Advantage, Medigap, Extra Help and Medicare Savings options that reduce health costs and preserve money for care.
Who qualifies: Medicare beneficiaries, people approaching Medicare and caregivers can use the service.
How to start: Call Missouri SHIP for one-on-one counseling.
Good to know: Family caregiver payment: No.
Medicare / Medicaid Cost Sharing
Medicare Savings Programs
Offsets health costsHelps pay for: For qualifying low-income Medicare beneficiaries, Medicaid programs may help pay Medicare premiums and sometimes cost sharing, freeing income for home care.
Who qualifies: Income/resource limits and category rules apply.
How to start: Apply through Family Support Division/MO HealthNet and ask Missouri SHIP for screening help.
Good to know: Family caregiver payment: No.
Medicare / Prescription Costs
Extra Help (Part D LIS)
Offsets medication costsHelps pay for: Federal Extra Help can reduce Medicare Part D premiums and prescription cost sharing, preserving income for care.
Who qualifies: Income/resource eligibility under Social Security/Medicare rules.
How to start: Apply through Social Security or ask Missouri SHIP for help.
Good to know: Family caregiver payment: No.
Insurance
Traditional Long-Term Care Insurance
Direct home-care payerHelps pay for: Existing policies may reimburse or pay a daily/monthly benefit for qualifying home care after benefit triggers and elimination periods are met.
Who qualifies: Policy terms, ADL/cognitive trigger, elimination period and approved-provider rules apply.
How to start: Request the full policy and open a claim with the insurer.
Good to know: Family caregiver payment: Sometimes, policy-specific.
Hybrid Life + Long-Term Care Policy
Direct home-care payerHelps pay for: Combination policies may accelerate a death benefit or provide a separate LTC pool for qualifying home-care expenses.
Who qualifies: Must own a qualifying policy and meet its benefit trigger.
How to start: Request an in-force illustration and benefits explanation from the carrier.
Good to know: Family caregiver payment: Policy-specific.
Insurance / Life
Accelerated Death Benefit / Chronic Illness Rider
Cash / indirectHelps pay for: Some life policies allow early access to death benefits for terminal/chronic illness and may provide cash that can be used for care.
Who qualifies: Policy-specific diagnosis/ADL rules and limits apply.
How to start: Ask the life insurer for rider and accelerated-benefit terms.
Good to know: Family caregiver payment: Yes, indirectly.
Private Pay
Savings / Retirement Income
Direct home-care payerHelps pay for: Social Security, pensions, IRA/401(k) withdrawals, savings and investments can be used directly for home care.
Who qualifies: No program eligibility, but tax and retirement-sustainability consequences should be considered.
How to start: Build a monthly care budget and compare agency/direct-hire options.
Good to know: Family caregiver payment: Yes.
Direct-Hire Caregiver
Direct home-care payerHelps pay for: Hiring a caregiver directly may reduce hourly cost, but the household may become the employer and owe payroll/tax/insurance obligations.
Who qualifies: Household-employer classification, wage/overtime, workers compensation and tax rules may apply.
How to start: Use a written agreement and payroll process; consult tax/legal help.
Good to know: Family caregiver payment: Yes.
Private Pay / Family
Family Care Agreement
Direct home-care payerHelps pay for: A care recipient can privately compensate a relative under a properly documented personal-care agreement.
Who qualifies: Agreement should be prospective, reasonable and documented; Medicaid transfer rules may matter later.
How to start: Consult an elder-law attorney before significant family payments if Medicaid may be needed.
Good to know: Family caregiver payment: Yes.
Financial Planning
Annuity Income
Cash / indirectHelps pay for: An annuity may convert assets into a predictable income stream that can be used for home-care bills.
Who qualifies: Product liquidity, fees, tax treatment and Medicaid consequences vary.
How to start: Review with a fiduciary adviser and elder-law attorney when Medicaid planning matters.
Good to know: Family caregiver payment: Yes, indirectly.
Home Equity
Home Equity Loan / HELOC
Cash / indirectHelps pay for: Homeowners may borrow against equity to pay current care costs.
Who qualifies: Requires sufficient equity, underwriting and ability to carry debt; variable rates may apply.
How to start: Compare lender terms and assess long-term affordability.
Good to know: Family caregiver payment: Yes, indirectly.
HECM Reverse Mortgage
Cash / indirectHelps pay for: Eligible homeowners age 62+ may access home equity without traditional monthly principal-and-interest payments, subject to occupancy, tax, insurance and maintenance obligations.
Who qualifies: HECM age/property/equity and counseling requirements; loan balance grows over time.
How to start: Speak with a HUD-approved reverse-mortgage counselor before signing.
Good to know: Family caregiver payment: Yes, indirectly.
Tax Strategy
Medical Expense Deduction
Tax offsetHelps pay for: Certain qualified long-term-care or nursing-type expenses may count as itemized medical expenses when IRS requirements are met.
Who qualifies: Qualified care, documentation and AGI threshold rules apply; ordinary household help is not automatically deductible.
How to start: Keep care plans, invoices and task breakdowns; consult tax adviser.
Good to know: Family caregiver payment: No.
Health Savings Account (HSA)
Tax-free funds / indirectHelps pay for: Existing HSA funds can be used tax-free for qualifying medical expenses and certain qualified long-term-care expenses/premiums.
Who qualifies: Expense must be HSA-qualified and not otherwise reimbursed.
How to start: Review HSA rules before paying home-care invoices.
Good to know: Family caregiver payment: No.
Child and Dependent Care Credit
Tax offsetHelps pay for: An employed taxpayer may qualify for a credit for care of a spouse or qualifying dependent who is incapable of self-care when the expense enables work or job search.
Who qualifies: Dependency, work-related expense, provider and other IRS rules apply.
How to start: Review Form 2441 requirements with a tax professional.
Good to know: Family caregiver payment: No.
Missouri Property Tax / Cost Offset
Missouri Property Tax Credit (MO-PTC)
Offsets household costHelps pay for: Qualifying seniors and people who are 100% disabled may receive a state property-tax credit based on rent or real-estate taxes paid, preserving household cash for care.
Who qualifies: Statutory age/disability, residency and household-income rules apply; maximum credit is generally up to $750 for renters or $1,100 for owner-occupiers.
How to start: Review Missouri DOR eligibility and file the applicable MO-PTC forms.
Good to know: Family caregiver payment: No.
Workers Compensation
Workers Compensation Medical / Home Care
Conditional home-care payerHelps pay for: For a compensable work injury, Missouri workers compensation can cover authorized medical treatment; medically necessary home health or related care may be covered when properly authorized.
Who qualifies: Must arise from a compensable work injury and be authorized under workers-comp rules.
How to start: Ask the employer/insurer and treating provider about authorized home-based care; consult counsel for disputed claims.
Good to know: Family caregiver payment: Case-specific.
Auto / Liability
Liability or Accident Settlement
Cash / indirectHelps pay for: Settlement proceeds from an accident or injury may be structured or reserved to pay future home-care expenses.
Who qualifies: Depends on claim, settlement terms, liens and tax/legal issues.
How to start: Coordinate with attorney and financial adviser.
Good to know: Family caregiver payment: Yes, indirectly.
Charitable / Community
Disease-Specific or Charitable Grants
Sometimes / limitedHelps pay for: Some nonprofit foundations, faith communities and disease-specific organizations offer limited grants, respite, transportation or practical assistance.
Who qualifies: Program-specific diagnosis, geography, income and funding limits apply.
How to start: Ask a hospital social worker, AAA or disease-specific organization about current assistance.
Good to know: Family caregiver payment: Usually no.
Cost Reduction
Senior Community Service Employment Program (SCSEP)
Offsets household costHelps pay for: Paid part-time community-service training can provide income for eligible unemployed low-income adults age 55+, helping offset household and care costs.
Who qualifies: Age 55+, unemployed and generally household income at or below 125% of the federal poverty level; priority rules apply.
How to start: Contact Missouri’s SCSEP provider network through DHSS/AAA.
Good to know: Family caregiver payment: No.
Missouri Senior Farmers’ Market Nutrition Program
Offsets household costHelps pay for: Eligible low-income older adults in participating areas can receive a seasonal benefit for locally grown fruits, vegetables, honey and herbs, reducing food spending.
Who qualifies: Generally age 60+, income eligibility and residence in a participating county; annual funding/availability applies.
How to start: Use the Missouri aging food-program page or local AAA for participating locations.
Good to know: Family caregiver payment: No.
VA Benefits
VA Homemaker & Home Health Aide
Direct home-care payerHelps pay for: VA may pay an authorized community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply.
How to start: Ask the VA social worker or primary care team.
Good to know: Family caregiver payment: No.
Veteran-Directed Care
Direct home-care payerHelps pay for: Provides a flexible self-directed budget for eligible Veterans needing personal care; workers may include family or neighbors subject to program rules.
Who qualifies: Enrolled Veteran; community-care eligibility; clinical criteria; local program availability.
How to start: Ask the VA social worker whether VDC is available locally.
Good to know: Family caregiver payment: Yes.
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from community providers for eligible Veterans.
Who qualifies: Clinical need, VA eligibility and authorization/local availability.
How to start: Ask the VA care team for skilled home-health assessment/referral.
Good to know: Family caregiver payment: No.
VA Respite Care
Yes - respiteHelps pay for: VA may pay for in-home, adult-day or nursing-home respite for eligible Veterans when caregivers need a break.
Who qualifies: Clinical need, enrollment, availability; community-care eligibility for community providers.
How to start: Ask the VA social worker/caregiver support coordinator.
Good to know: Family caregiver payment: No.
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional monthly VA pension payment for qualifying Veterans/survivors who need help with daily activities or meet other criteria; cash can be used toward care.
Who qualifies: Must first qualify for VA pension plus Aid & Attendance criteria; medical and financial rules apply.
How to start: Use VA or an accredited representative to apply.
Good to know: Family caregiver payment: Yes, indirectly.
PCAFC Caregiver Stipend
Direct caregiver stipendHelps pay for: VA may pay an approved primary family caregiver a monthly stipend and provide respite, training, counseling and other supports.
Who qualifies: Veteran and caregiver must meet PCAFC eligibility and complete VA assessment/enrollment.
How to start: Apply jointly through VA Caregiver Support.
Good to know: Family caregiver payment: Yes.
VA Community Care Network - Region 2
Pays authorized providerHelps pay for: VA-authorized community care can include home health and other approved services. Missouri is in CCN Region 2, administered by Optum.
Who qualifies: VA referral/authorization and community-care eligibility generally apply.
How to start: Obtain VA authorization before routine community care; do not assume reimbursement after private hire.
Good to know: Family caregiver payment: No.
Where Missouri Families Can Start
Not sure where to begin? Match your situation to a contact below.
Request or change in-home HCBS, including Agency Model, CDS, ADW, ILW, SFCW and other DSDS-administered services
DSDS HCBS Intake & PCCP
Medicaid coverage, eligibility/benefit questions and MO HealthNet navigation
MO HealthNet Constituent Services
Connect by ZIP code to the local AAA for in-home services, caregiver support, meals, transportation and benefits help
Missouri Senior Resource Line
Dementia caregiver respite, training, assistive technology and qualifying expense reimbursement when funding is available
Missouri Caregiver Program
Medically Complex Adult Waiver referrals and service coordination
Special Health Care Needs / MCAW
Integrated medical and long-term services/supports for qualifying adults 55+ in participating service areas
Missouri PACE
Transition from qualifying nursing-facility stay to home/community
Show-Me Home
Free Medicare, Medicare Advantage, Medigap, Medicare Savings and Extra Help counseling
Missouri SHIP
Apply for SNAP, Medicaid and other income-support benefits
myDSS / Family Support Division
Connect to local VA caregiver and home/community services
VA Caregiver Support Line
Assessment for VDC, respite, home health, HHA and CCN
VA Health Care / Social Work
Before You Rely on Any Payment Source
Start with DSDS HCBS + the local AAA
Call HCBS Intake/PCCP at 866-835-3505 for Medicaid HCBS screening and the Senior Resource Line at 800-235-5503 for non-Medicaid aging programs, meals, transportation, caregiver support and local services.
CDS can pay many family members
A CDS participant is employer-of-record and may hire a family member, but the attendant cannot be the participant’s spouse or legal guardian. The enrolled CDS provider handles payroll on the participant’s behalf.
Agency Model has stricter family-worker rules
Missouri’s Agency Model in-home services do not allow an immediate family member to be the caregiver, so families seeking to hire a relative should ask specifically about CDS eligibility.
SFCW is a distinct dementia caregiver pathway
The Structured Family Caregiving Waiver is for qualifying people with Alzheimer’s disease or related dementia who live with a primary caregiver. The participant cannot receive another HCBS/waiver service, and the primary caregiver may not maintain outside employment.
ADW is a key pathway for adults 63+
The Aged and Disabled Waiver can cover homemaker, chore, meals, respite and adult day care for qualifying people who meet Medicaid and nursing-facility-level-care criteria.
ILW rules changed July 1, 2026
The Independent Living Waiver supplements CDS for qualifying physically disabled participants with higher needs. Effective July 1, 2026, ILW services are subject to a 49-hour-per-week limit.
ADW respite also has a 49-hour weekly limit
Missouri’s FY27 HCBS changes established a 49-hour-per-week limit for respite under the Aged and Disabled Waiver; existing care plans over the limit require adjustment under state guidance.
Missouri Caregiver Program funding is limited
The dementia caregiver program can help with respite, assistive technology and qualified expenses, but funding is availability-based and it is not a continuous caregiver wage.
PACE is service-area dependent
PACE can be one of the broadest home/community funding pathways for qualifying adults 55+, but the person must live in the service area of a participating Missouri PACE organization.
Do not confuse Medicare with long-term custodial care
Original Medicare may cover qualifying intermittent skilled home health and limited aide care tied to a skilled need, but it does not generally pay for ongoing custodial personal care when that is the only need.
VA CCN requires authorization
Missouri is VA CCN Region 2, administered by Optum. Families should obtain VA referral/authorization before using routine community providers rather than assuming a private hire will be reimbursed.
Use cost offsets and document private family pay
Property-tax credits, food/energy help, Medicare savings and insurance can preserve dollars for care. If paying a relative privately, use a prospective written care agreement and good records, especially if Medicaid eligibility may be needed later.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Missouri to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Missouri
These providers serve families in Missouri and can help you apply what you've learned above to your specific situation.
Adelmo Family Care
Serving Missouri
Adelmo Family Care provides home care services in Webb City, MO and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Joplin, Webb City
View Provider Profile →
All Family Care
Serving Missouri
All Family Care provides home care services in St. Louis, MO and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
St. Louis
View Provider Profile →
Avalon Park
Serving Missouri
Avalon Park is an independent senior living community in Cottleville, MO, offering private residences with maintenance, meals, and activities for older adults who manage their own daily care.
Services Available
Independent Senior Living
Communities Served
Cottleville, St. Charles County
View Provider Profile →
AW Health Care – O’Fallon, MO
Serving Missouri
AW Health Care provides home care services in O’Fallon, MO and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Illinois
View Provider Profile →
AW Health Care – St. Louis, MO
Serving Missouri
A Comprehensive, All-Inclusive Approach to Lifelong Well-Being At AW Health Care, we’re committed to supporting your health journey at every stage of life. Through personalized in-home care, outpatient therapy, adult day program, skilled nursing and therapy rehabilitative services, we care for the whole person—body, mind, and spirit. Because everyone deserves to live and age well, with dignity and peace of mind.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Illinois
View Provider Profile →
Elder Care of Kansas City
Serving Missouri
Elder Care of Kansas City provides home care services in Kansas City, MO and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Jackson County, Clay County, Platte County and surrounding areas
View Provider Profile →
Pear Tree Home Care
Serving Missouri
Pear Tree Home Care provides home care services in Des Peres, MO and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Arnold, Brentwood, Chesterfield and surrounding areas
View Provider Profile →
StaffLink USA
Serving Missouri
StaffLink USA provides home care services in St. Louis, MO and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
St. Louis City, St. Louis County, Affton and surrounding areas
View Provider Profile →